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GPs warn of unintended consequences of new AstraZeneca Covid vaccine advice

booster doses

GPs have warned of unintended consequences from the Government’s latest AstraZeneca Covid vaccine advice, including creating ‘panic’ among patients and adding to the workload of already pressured practices.

After establishing an ‘extremely rare’ blood clot risk, the Government this week said under-30s who should be offered an alternative Covid vaccine to the Oxford/AstraZeneca jab.

Meanwhile all scheduled appointments for under-30s were cancelled while patients were urged to discuss their vaccination with their GP.

But Nottingham GP partner Dr Irfan Malik told Pulse the new advice ‘created panic’ among patients – even though the risk of clots is very small.

He said: ‘Patients and the public have become very concerned about the risk of clots with the Astra Zeneca vaccine – they are declining to have it. I’m afraid this has been badly managed and stopping the under-30s from having the vaccine has alarmed the public.

‘The changes have led to a substantial increase in calls to practices creating a further huge increase in workload.’

And Peterborough GP and PCN clinical director Dr Neil Modha told Pulse that his vaccination clinic yesterday saw 10 DNAs. 

‘I must have spoken to about four people this morning about the vaccines and it’s also driven some worries about the other vaccines as well’, he said.

‘It’s not just under-30s who are calling, the person who I just spoke to was 53, so it’s just general increased anxiety unfortunately about the vaccine programme. And then people have been signposted to their GPs for conversations and they’re not easy and simple conversations, you need to give people time and space to have them.’

Dr Modha warned of the toll this would take on already exhausted colleagues, saying he’s ‘hearing a lot more about stress and burnout’.

Bristol academic GP Dr Lucy Pocock told Pulse the move asking patients to contact their GP for advice could lead to practice staff facing further abuse – an ongoing issue throughout the pandemic.

She said: ‘It’s just such an unhelpful and inconsiderate statement from NHS England, showing again that they have no concept of the pressures that we are currently facing in primary care. 

‘Yet again, it will be our front-facing reception staff who bear the brunt of this, which is likely to result in them receiving abuse when they cannot provide people with the information that they are expecting.’

Lincolnshire LMC medical secretary Dr Kieran Sharrock added: ‘They should be contacted by NHS England or somebody else rather than [their GP] – whilst we’re dealing with their calls we could be dealing with other patients who are actually sick’.

And he said that while not many under-30s are eligible for the jab yet, ‘even one or two extra calls a day on top of the tsunami we’re already getting doesn’t help’.

Meanwhile, Wessex LMC chief executive Dr Nigel Watson warned that the new consent model risks slowing down the programme, while increased hesitancy among the over-30s – who won’t be offered an alternative – could lead to people not being vaccinated at all.

He said: ‘We’ve been processing at a certain rate and it’s going to take longer with the consent model. But I don’t think it’s just younger people, I think the older people will also be questioning the AstraZeneca [vaccine].

‘Many practices are sitting on quite a lot of AstraZeneca now because we’ve exhausted the people we can call in in cohorts one to nine. I suppose one of the questions is how the 30-50-year-olds will accept the AstraZeneca, which we obviously don’t know at the moment.’

Many other GPs took to Twitter to express frustration over the announcements, with one Tower Hamlets GP describing it as a ‘heartsink moment’.

And former BMA clinical and prescribing policy lead Dr Andrew Green warned of the long-term implications of the decision.

Meanwhile, the deputy chief medical officer has said that the new advice should not stop the Government from hitting its vaccine rollout targets.

The Government has set a target for all patients in priority groups one to nine to have been offered their first Covid shot by 15 April.

Phase two – cohorts 10 to 12 – will begin once it is formally authorised by the Government, which has a target for all adults to be offered a first dose by 31 July.

Additional reporting by Eleanor Philpotts


Andrew Bamji 9 April, 2021 11:29 am

It is highly likely that the clotting phenomenon described is the same immune thrombocytopenia as is seen in Covid-19. As the problem appears to be specific to the Oxford vaccine it is probably caused by a cross-reaction from the spike protein-induced antibodies. My guess is that anyone who gets the vaccine-induced form would have got it had they developed Covid-19 itself (where it may occur in around 50% of severe cases).

It matters if the signs and symptoms remain unrecognised, but as there is established treatment that works if may not matter too much.

Joanna Rudnicka 9 April, 2021 12:06 pm

I’m all for transparency even if the risk is tiny, patients have the right to know and decide. This is informed consent. And yes, it may and most likely will generate more work for us all, but we have a duty of care for our patients.

Neil Tallant 9 April, 2021 6:22 pm

I think the risk evaluation will be self determined. Clearly the risk of serious CoViD in under 30’s is very small compared with the over 60’s. Apart from a few, all I have seen to vaccinate in the respective cohorts are more than happy to have it on an expectation of protection and a hope that it will hasten a return to “Normality”. It still does seem that the risk:benefit ratio in under 30’s does have to be explained but on this point alone if they are prepared to take the risk of travelling (1:100,000 risk of injury) then there is little argument to have with them.
Again we really do need to have a risk evaluation score that below a certain point needs no further discussion. After all life itself is a risk – unless you reside in utopia.

Richard Greenway 12 April, 2021 6:39 pm

Allowing people to decide with informed consent is fine.
But a blanket cut off at an arbitrary age, with immediate cancellation of appointments diminished choice. Also coupled with contradictory advice not to give Pfizer (or any) 1st doses. As we vaccinate millions of patients, we will unearth the 1 in a million risks for sure. These will exist with all of the brands of vaccine, as they do with most medicines I prescribe on a daily basis.